Tuesday, March 27, 2007

Last one... for now!

So I had my last 2 appointments today... I went to the IRM and I got my new shoe orthotic and so far so good. It feels good to walk on, no pain or cramps. Then I went to the MGH for hip and pelvis x-rays... let's hope the doctor calls me soon to tell me what's next, apart from the Botox for my leg. I want to know if the x-ray shows anything or not.

And the saga continues...

Monday, March 26, 2007

"Raising Research Awareness through Simple, Fun Activities"

This post was taken from the new hospital librarian's wiki sponsored by the Hospital Libraries Section of the Medical Library Association. It has some very creative promotional ideas that Nursing Research Councils could use or adapt to promote interest in nursing research.

"Following you will find the abstract for the poster presentation we submitted. It is a list of activities we have done with the Research Council at Rex Healthcare. You might find it helpful.

Title: Raising Research Awareness through Simple Fun Activities

Authors: Deniz Ender, Librarian, MLS, AHIP: Sally Williford, RN, MSN, CCRN, Nurse Educator and Joan Cederna-Moss, RN, MSN, Clinical Nurse Specialist, Rex Healthcare, Raleigh, NC.

Objective: The objective of this activity is to increase staff participation in research projects by capturing interest in research and demonstrating the research process through easy, fun, interactive research activities. To foster interest in research, the hospital librarian worked with nurse educators to design several easy-to-implement, interactive activities. A byproduct of these events was the development of an excellent working relationship between the medical library and clinical staff in the hospital.

Methods: Activities that appeal to a variety of learning styles and abilities were planned to raise staff research awareness.Nursing Research Surveys –Surveys were done in 2004 and 2006 to gauge staff opinions regarding research. This year our Research Council will share the results and provide feedback about how concerns were addressed.“Taste tests”– Staff were invited to compare food products (cookies, chips, crackers and cereals) to detect the difference between the “name brand” product and the “low fat, low calorie, or store brand product”. Voting was done via colored beans.Logo contest – Staff were encouraged to submit a design for use as the Research Council’s logo. Entry rules specified that the design must “support evidence-based practice” and must meet facility requirements for logo use.Results: Staff responded with interest to “taste tests”, often asking “when will we know the results?” The results were calculated and communicated using research terminology such as “single blinded study” and “hypothesis” to further boost research awareness. After the selection of the logo/icon “winners”, we plan to showcase the winning designs on our house wide computer log-in screens or bulletin boards. Research awareness activities can be done alone or in conjunction with “Research Awareness Month”.

Conclusion: Our staff eagerly participated in these fun events that raised their interest in conducting research projects. As a result, they are more knowledgeable about the research process and more willing to participate in a study. The library’s role as the “supply garrison” for research information was enhanced through participation in these activities. Other librarians wishing to solidify the library’s essential place in the research process could adapt these activities for use in their hospital. "

Thursday, March 22, 2007

Human Pincushion

And so, I am nearly done with hospital appointments for a little while at least... 2 more next Tuesday. Today I had bloods drawn, fun stuff! I now have a bruise and welts from where the stupid tape was. I never used to react to the tape, now it would appear that I do.

I must say that I much prefer it when I am the one poking my patients, and not the one being poked, though I admit I am so very used to it now!

So next week, X-Rays of my hips and pelvis and getting my new shoe orthotic!

And the fun continues...

OK, had test #2 at the neurophysiology lab. This one was called a cutaneous electrogastrography and using the water load/water challenge test. I was sitting/lying in a huge recliner (Lazy-Boy style) with 3 electrodes on my stomach. They took readings for 10 min, then I had to drink as much water as I could until I felt full, and then they took more readings for another 30 min. Basically I caught up on sleep! Yes, I fell asleep!

So after downing nearly 500cc of water and waiting 30 min I seriously had to pee. Thank god the washroom was NOT occupied!

Travel Nurse: Change of Shift is Up at Codeblog

I just read the latest edition of Change of Shift at Codeblog and I must say some of the most creative blogs I've read are those written by nurses. A limerick for St. Patty's Day is a nice touch.

Monday, March 19, 2007

March Break Madness

The above pics are of an autonomic neurophysiology lab... this is one of the tests I went through last week. I'll see if I can bring my camera and get pics taken of me...

Ok, so the title makes it sound like I am at some fancy beach resort... I'm not, I'm here in cold Montreal.

What I mean by this title is the fact that now that I have some "down-time" I am still running around! I have doctor/hospital appointments scheduled all week!

Monday: MGH doctor appt for my hip
Wednesday: JGH test in the neurophysiology lab
Thursday: blood tests
Tuesday: IRM for my new shoe orthotic and after the MGH for x-rays
(5 appointments in 4 days)
in between these, I am studying, doing errands and hopefully a bit of shopping!

At least by going to the MGH I get to see my friends as in my ex-nurses/PT/dietician/neurologists... same for the IRM, makes it more fun. I was speaking to one of the neuros I had 3 yrs ago, she could not get over the changes/improvemnents. Pretty neat to be able to amaze doctors!

Sunday, March 18, 2007

Update on med-surge II

Well, I have made it through the first 6 weeks! AND I LOVE IT! Who knew? I am learning so much each time I go and really find that nursing is what I am meant to do. I am doing new skills and feel like a "real" nurse. I still hate the fact that the place is a maze, and as long as I don't stray far from where I know I am ok, hehe.

My group is great, we all help each other and really do work well as a team. The nurses on the floor are really nice and most enjoy teaching us too. Some really take the time to explain things to us and let us get a ton of hands-on experience. My clinical teacher is nice and trusts us and jokes with us (she changed her opinion about me having a disability and no longer doubts my abilities). It is a nice feeling not to be intimidated all the time. I find I learn so much better this way.

6 more weeks to go.. or 7, not sure, what with March break... (which I am on now!). Wish me luck!

Today also marks 3 since I got Transverse Myelitis. In a way, it is a "good" thing; made me want to become a nurse even more, gave me insight into how patients feel and will make me a better nurse. So I guess it isn't all bad (paralysis and all), more challenging for sure and I still have some doubts, but what student nurse doesn't?

(The pics are of me now, participating in my school's Open House and of me back in 2004, when I was in the hospital and saying that I would become a nurse!)

Wednesday, March 14, 2007

Travel Nurse: He Jumped Out of A Moving Car!?

This morning a 35 year old man with more head, neck and you-name-it injuries than I can count was moved to my floor from the E.R. The man had jumped out of a moving car going 75 miles per hour on the interstate. A Dare maybe? No. Something wrong with the car's brakes? No. Drunk perhaps? Well, that has something to do with it even though it was 7:00 in the morning when he jumped out of the car.

Apparently the man and his girlfriend had been drinking throughout the night. When dawn finally came they decided to climb into their car and drive home on the interstate while still intoxicated. During the course of the drive home the man and his girlfriend got into an argument and she told him she was through with him. This was the straw that broke my poor, alcoholic patient's back (literally). In a fit of passion (or stupidity) he flung open the passenger's side door and jumped. The man cracked his skull, broke his back and lost much of the skin on his body. He is likely not going to survive past the weekend.

Now you may think I am being a little flippant with my treatment of this patient's current medical state. But consider this: I found out from his relatives that this was the third time he had jumped out of a moving car (though not going quite so fast) after being dumped by the same girl. Combine that with the fact that he and his girlfriend were intoxicated while flying down the interstate and maybe my attitude in writing this post can be understood; though maybe still not justified.

Highway Hypodermics Travel Nursing 2007

Are you thinking in becoming a travel nurse but don't know a thing about it?
This easy-to-read book "Highway Hypodermics Travel Nursing 2007" by Epstein La Rue RN, BS, Travel Nurse, can take you through all of the necessary steps to become a traveling nurse.
It gives you the pros and cons of travel nursing, important reviews of most of the top travel nursing agencies with a clear style and a great sense of humor. It is a MUST for any nurse thinking about the issue.

Thursday, March 8, 2007

Travel Nurse: Thank Goodness I'm with an Agency

Yesterday the hospital administration decided to break the news to the nurses. I had just clocked in and was about to start my shift when the nurse manager asked the nurse on the shift before me if she could stay 30 minutes longer. She then told me that an "emergency meeting" had been called and that I was to report to the conference room immediately. When the nurse manager walked away the nurse on the shift before me said "It's your turn to hear the good news." I asked her what she meant by that, but she just said "Oh, you'll see." I have been at this assignment long enough to know that meetings in the conference room are rare, and often mean something drastic is going to happen.

When I walked into the conference room the nurse manager, several people in suits and ties and about a dozen other nurses and nurse techs were already seated around a long table. The nurse manager started the meeting by saying "Now PROMISE me you won't quit once you've heard what I have to say." An ominous way to start any meeting. She then went on to say that the hospital's patient census is higher than it has ever been at the hospital, but that the hospital does not intend to add any more nurse/nurse tech positions. She said that the cap of 7 patients maximum per nurse had been a cap set by the hospital and that the hospital was now changing it. There would no longer be a cap on patient load. Nurses immediately started mumbling under their breaths.

The meeting was short and I could tell the nurse manager had been forced to make the announcement by the suits and ties. She didn't seem any happier about the decision to remove the patient cap than anyone else.

So what does this mean to me as a travel nurse? Fortunately, I have a contract with my travel nurse agency that limits the number of patients I can be required to tend to 6. The problem I now face is enforcing that provision. I now have to deal with the nurse manager's reaction when I remind her of the patient load limitations in my contract. That will probably be something I do tomorrow. And then there are the other nurses' reactions when they find out about my contract. Just one of the things you have to deal with as a travel nurse I guess.

Oh, and by the way, as for the nurse manager's request not to quit. I saw two nurses thumbing through the employment section of the newspaper yesterday during our shift. This should get interesting.

Travel Nurse: Change of Shift

Change of Shift is up over at Emergiblog. Check it out and, as Kim says, bring your kleenex tissues.

Wednesday, March 7, 2007

Dana Rutledge Phd, RN receives ONS "Ellyn Bushkin Friend of the Foundation Award"

Our very own Dana Rutledge, PhD, RN, Nursing Research Facilitator at St. Joseph Hospital in Orange, California, recently received the prestigious "Ellyn Bushkin Friend of the Foundation Award" from the Oncology Nursing Society Foundation. The ONS Foundation reports that the purpose of the award is to recognize individuals who have provided continuous support to the mission of the ONS Foundation. Nominations are not accepted for this award; rather, the ONS Foundation Board selects the recipient. "The nominee must have demonstrated support of the ONS Foundation by making major financial contributions, coordinating significant fund-raising events, or promoting/enhancing the image of the ONS Foundation". The award is named in the memory of Ellyn Bushkin, an oncology nurse and a past president of the ONS Foundation.

Congratulations Dana!! You are so modest that we had to hear of this award second hand. Hope you don't mind our public congratulations!!

Tuesday, March 6, 2007

It's coming! Nurses Week 2007

The theme for "Nurses Week 2007" has been announced by the American Nurses Association: "Nursing: a Profession and a Passion". Nurses Week is going to be celebrated from May 6 (Nurses Day) through May 12 (Florence Nightingale's birth). You can see all the details here.

Monday, March 5, 2007

Julie's picks from the Nursing Literature Feb 2007

These recent articles in the nursing literature made my list of "picks" as being especially interesting from an EBN point of view. Articles with an ** should be available at Burlew Medical Library, either electronically or in print.

1. Tannery, Nancy Hrinya, Wessel, Charles B, Epstein, Barbara A, Gadd, Cynthia S. Hospital nurses' use of knowledge-based information resources. Nursing Outlook 2007 55:15-19 2007 Jan-Feb **

2. Barron, J, Petrilli F, Strath, L, McCaffrey R. Sucessful interventions for smoking cessation in pregnancy. MCN:The American Journal of Maternal/Child Nursing 32(1):42-9 2007 Jan-Feb **

3. Hook, ML, Winchel S. Fall-related injuries in acute care: reducing the risk of harm MEDSURG Nursing 2006 Dec 15(6):370-7, 381 **

4. Mathieson, C, Tavianini, HD, Palladino K. Best practices in stroke rapid response: a case study. MEDSURG Nursing 2006 Dec 15(6):364-9 **

5. Gaskamp C, Sutter, R, Meraviglia M. Evidence-based guideline: promoting spirituality in the older adult. Journal of Gerontological Nursing 2006 Nov; 32)11):8-13 **

6. Goldhill DR, Imhoff M, McLean B, Waldmann C. Rotational bed therapy to prevent and treat respiratory complications: a review and meta-analysis. American Journal of Critical Care 2007 Jan 16(1):50-62 **

7. Cason, CL, Tyner, T, Saunders, S, Broome, L. Nurses' implementation of guidelines for ventilator-associated pneumonia from the Centers for Disease Control and Prevention. American Journal of Critical Care 2007 Jan 16(1):28-38 **

8. Tolentino-Delosreyes AF, Ruppert, SD, Shiao SPK. Evidence-based practice: use of the ventilator bundle to to prevent ventilator-associated pneumonia. American Journal of Critical Care 2007 Jan 16(1):20-7 **

9. Hermans, MH. Wound wise. Silver-containing dressings and the need for evidence: before choosing a specific dressing, take a look at the literature. American Journal of Nursing 2006 Dec 106(12):60-9 **

10. Low, LK, Miller, J. A clinical evaluation of evidence-based maternity care using the Optimality Index JOGNN 2006 Nov Dec 35(6):786-93 **

11. Murphy PA, Fullerton, JT. Development of the Optimality Index as a new approach to evaluating outcomes of maternity care JOGNN 2006 Nov-Dec 35(6):770-8 **

12. Mercer, RT, Walker, LO. A review of nursing interventions to foster becoming a mother. JOGNN 2006 Sep-Oct 35(5):568-82 **

13. Ahlqvist M, Bogren A, Hagman S, Nazar I, Nilsson K, Nordin K, Valfridsson BS, Soderlund M, Nordstrom G. Handling of peripheral intravenous cannulae: effects of evidence-based clinical guidelines. Journal of Clinical Nursing 2006 Nov 15(11):1354-61 **

14. Kleinpell, RM, Graves BT, Ackerman MH. Incidence, pathogenesis, and management of sepsis: an overview. AACN Advanced Critical Care 2006 Oct-Dec 17(4):385-93 **

15. Harrington L, Hoffman E, Allard PM, Adams BJ, Hamilton P, Wright K, Cargo V. Nursing research dashboard: a tool for managing your nursing research program Nurse Leader 2006 Oct 4(5):54-7

16. Zitella LJ, Friese CR, Hauser J, Gobel BH, Woolery M, O'Leary C, Andrews FA. Putting evidence into practice: prevention of infection. Clinical Journal of Oncology Nursing 2006 De4c 10(6):739-50, 781-3 **

17. Numata Y, Schulzer M, Van der Wal R, Globerman H, Semenluk P, Balka E, FitzGerald JM. Nurse staffing levels and hospital mortality in critical care settings: literature review and meta-analysis Journal of Advanced Nursing 2006 Aug 55(4):435-48

18. Funfgeld-Connett D. Meta-analysis of presence in nursing. Journal of Advanced Nursing 2006 Sep 55(6):708-14

Saturday, March 3, 2007

Americus, Georgia: Another Tornado Disaster

The devastation is incredible. My husband went to Americus, Georgia with a group from our church today. For those of you who don't already know, Americus was devastated by the same system of tornadoes that hit Enterprise, Alabama. Around 17 tornadoes hit Americus and wiped out the hospital, several large businesses and hundreds of homes.

I have heard that as many as 8 people were killed in Americus, but I don't know for sure.

The crew said the pictures just don't do the magnitude of the destruction justice. The first picture is a picture of the first house my husband and his group worked on. The owners of the home were elderly. One of the problems with their situation is that they were told insurance will not pay for their yard to be cleaned. Not even if trees are completely blocking the entrance.

The man in the picture below is 74 years old. My husband said he worked harder than anyone and didn't slow up all day.

Below is a picture of my brother-in-law chainsawing away. He loves to use his chainsaw and I am told he is really good at it.

The crew at the end of the day. My husband is the one at the end on the right.
This is the first house after the crew had finished.

These elderly ladies live in the first house the crew cleaned. Smiling faces after the clean-up.

My husband said when they first rolled into town there were Army helicopters flying all over the place. He found out later that most of the helicopters were securing the air for President Bush and other dignitaries to view the destruction from the air. Later that day he was crossing one of the major streets on foot when he overheard one of the police radios say President Bush would soon be coming down the street. He asked the officer if he could stay there to take a picture of the entourage when it came by. The officer okayed it with the Secret Service, so the pictures of the black SUV's are of President Bush's entourage.